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The authors ask you:
Type 2 diabetes disproportionately affects over 17 million people in the United States. Distressing or stressful events due to prolonged psychosocial or socio-economic injury influence processes related to uncontrolled glycemic levels and risk for diabetes. Police officers have one of the most stressful jobs in the United States when compared to the general population. The specific aims of this study are to evaluate the effects of perceived stress on glycemic levels in City of Birmingham police officers and to identify best predictors of glycemic levels. This will be a nonexperimental, correlational study employing a cross-sectional design. Descriptive analyses, multiple regression, and bivariate correlations will be used to analyze the data collected. These findings may be of importance to employers and occupational healthcare providers aiming to positively impact employee health outcomes of professionals, like police officers or public safety workers, of which increased stress levels are an inherent attribute of the work environment and organizational infrastructure.
Type 2 diabetes disproportionately affects over 17 million people in the United States. By 2025, greater than 200 million will be affected by diabetes mellitus (Rosmond, 2003; Skelly, 2006). Almost 25% of unfavorable outcomes and preventable consequences due to relentless progression of diabetes such as retinopathy, nephropathy, neuropathy, atherosclerosis, and vascular impairment can be minimized when optimal glycemic levels are achieved (UKPDS Study Group, 1998; Skelly, 2006; Berry & Melkus, 2006). Distressing or stressful events due to prolonged psychosocial or socio-economic injury influence processes related to uncontrolled glycemic levels and risk for diabetes. The synergistic effects yield hypercortisolemia, a product of the hypothalamic-pituitary-adrenal (HPA) axis, and increased catecholamines which have counterregulatory effects on insulin inducing disruption in feedback mechanisms, potentiating hyperinsulinemia, excessive storage and centralization of fat, or visceral obesity, and possibly Type 2 diabetes (Rosmond, 2003; Burén & Eriksson, 2005). Stressful working conditions have been associated with high HbA1c levels in diabetic and non-diabetic populations (Kawakami et al., 2000; Burén & Eriksson, 2005). Police officers have one of the most stressful jobs in the United States when compared to the general population (Li-Pang Tang & Hammontree, 1992; Simons & Barone, 1994; McCreary & Thompson, 2006). The organizational infrastructure and inherent characteristics of policing have been identified as two primary sources of stress (McCreary & Thompson, 2006) increasing the risk for hyperglycemia & diabetes due to the previously mentioned sequela.
The specific aims of this study are to evaluate the effects of perceived stress on glycemic levels in City of Birmingham police officers and to identify best predictors of glycemic levels.
This will be a nonexperimental, correlational study employing a cross-sectional design.Three self-administered, self-report questionnaires will be measured: a) Good Health Program Health Risk Appraisal, b) Operational Police Stress Questionnaire (PSQ-Op), and c) Organizational Police Stress Questionnaire (PSQ-Org).The study population will be a convenience sample of police officers obtained from the Good Health Program.This program has been maintained by the School of Nursing, University of Alabama at Birmingham, since 1991. Descriptive analyses, multiple regression, and bivariate correlations will be used to analyze the data collected.
While there is a significant amount of literature discussing potential links to perceived stress and glycemic levels as potential causal factor of Type 2 diabetes (Baum & Posluszny, 1999; Kawakami et al., 2000; Rosmond, 2003; Burén & Eriksson, 2005), there is minimal literature evaluating the effects of perceived stress on glycemic levels in high stress occupations like policing. Therefore this study will propose to evaluate the relationship between perceived stress and glycemic levels, BMI, and waist circumference, after adjusting for the set of individual factors, to determine the order and predictive ability of these factors and effects on health outcomes in police officers.
Research in progress
Research in progress
Implications: There is minimal literature available assessing the effectiveness of modeling/implementing concomitant stress management techniques in attainment of optimal glycemic control in the workplace. These findings may be of importance to employers and occupational healthcare providers aiming to positively impact employee health outcomes of professionals, like police officers or public safety workers, of which increased stress levels are an inherent attribute of the work environment and organizational infrastructure.
Baum, A. & Posluszny, D. (1999). Health psychology: Mapping biobehavioral
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Berry, D. & Melkus, G. (2006). Epidemiologic perspectives of risk for
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Burén, J. & Eriksson, J. (2005) Is insulin resistance caused by
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Kawakami, N., Akachi, K., Shimizu, H., Haratani, T., Kobayashi, F., and Ishizaki,
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(M. Weaver, personal communication, October 11, 2007). M. Weaver explained
in detail how the Good Health Program is currently implementing the KRW framework
and the theoretical underpinnings.
Rosmond, R. (2003). Stress induced disturbances of the hpa axis: A pathway
to type 2 diabetes. Medical Science Monitor, 9 (2), RA35-9.
Simons, Y. & Barone, D. (1994). The relationship of work stressors and
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Skelly, A. (2006). Type 2 diabetes mellitus. Nursing Clinics of North America,
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Tang, T.L., & Hammontree, M. (1992). The effects of hardiness, police
stress, and life stress on police officers’ illness and absenteeism.
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United Kingdom Prospective Diabetes Study Group (1998). Effect of intensive
blood-glucose control with metformin on complications in overweight patients
with type 2 diabetes (UK-PDS-34). Lancet, 352, 854-856.
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